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Press Release
Press Release
Compton Billed Insurers for Numerous Counseling Sessions that he did not Provide
GRAND RAPIDS, MICHIGAN —Acting U.S. Attorney Andrew Byerly Birge announced that George E. Compton, Jr., 63, of Sturgis, Michigan, pled guilty today in federal court to a felony information charging him with executing a health care fraud scheme from at least January 1, 2013, until June 30, 2016. Compton will be sentenced at a date to be determined by the court, at which time he will face a maximum prison term of 10 years, a fine of up to twice the amount of the gross gain from his fraud, and he will be ordered to make restitution to his victims.
According to court records, Compton defrauded health care benefit programs of at least $250,000.00. As part of the scheme to defraud, Compton established legitimate relationships with numerous patients, provided periodic counseling sessions to his patients, and billed their health care benefit programs. However, after establishing these relationships, Compton regularly billed his patients’ health care benefit programs for counseling sessions that grossly exceeded the number of actual counseling sessions that he provided. When his patients or the health care benefit programs occasionally detected his excess billings, Compton furthered his scheme to defraud by falsely claiming that the billings were the result of an honest mistake or the automated billing functions of his billing software and he reimbursed the health care benefit program for the over-payment. Additionally, when audited by one of the health care benefit programs, Compton further carried out the scheme to defraud by providing the health care benefit program with fake patient counseling notes in an attempt to make it appear as if he actually provided counseling sessions on dates that he knew he had previously submitted false billing. On at least one occasion, he billed for counseling sessions that he claimed occurred at his Coldwater office despite the fact that he was actually in Pittsburgh, Pennsylvania. On another occasion, he billed for counseling sessions for a patient that was actually hospitalized in an induced coma and later homebound.
"Unfortunately, this case represents yet another example of how some health care professionals allow their own greed to lead them down the path of defrauding health care benefit programs and ultimately harming consumers of health insurance," said Birge. "My office will continue to vigorously prosecute those who commit health care fraud against private or public health insurance plans."
"Today’s guilty plea should serve as a warning that those who place their own greed for profits above honest billing practices will be identified and prosecuted," said David P. Gelios Special Agent in Charge, Detroit Division of the FBI.
The case was investigated by the Kalamazoo office of the FBI and is being prosecuted by Assistant U.S. Attorney Ronald M. Stella.
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